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2nd and final qustion for RLR, Thank You (Read 2036 times)
lee67
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2nd and final qustion for RLR, Thank You
Dec 20th, 2010, 9:28am
 
Re: Medical opinion required if possible, thank you
Brilliant many thanks for your reply RLR.. Why have all the doctors I have seen not taken the time to explain that to me. So moving forward is a coping strategy to the way my body is and to accept that I have a delicate nervous system. My diet is quite normal no cereal bars or supplements, I eat three meals a day and try not eat too much bread and drink lots of water (no fizzy drinks at all, I do love the taste of water). I have been burping this morning and I have had one cup of tea.

If it is normal to experience bouts of 180 bpm and can do me no harm, what should I do when I get episodes of 180 BPM after bending down, I would think to eat smaller meals? I have given up cycling for the moment because it was happening so frequently that I would ride for 10 miles and BAM one big palpitation then I feel awful and struggling to breath, no chest pain just shear exhaustion and feeling very sick to the stomach. I always cycle with an empty stomach so not indigestion related but I do burp whilst exercising. My partner and I used to walk together but I am now paranoid after going on a few walks (5 miles) and Bam the same again what feels like one big palpitation coming (like butterflies in my upper abdomen) and it hits. I am then immobilised and can’t move, completely exhausted again no chest pain just exhausted and have to lie down wherever it happens.

Again after an episode I feel like I have been beaten up and very weak which makes walking anywhere a very slow process. I do not think these episodes are psychological as I have always enjoyed exercise and I love the release of endorphins it gives me when I return, I used to say the feeling was as good as sex! It is difficult to give up exercise as I really believe it is vital for good health and I miss not cycling for half an hour every day and doing a small number weight reps for general fitness purposes. Its funny how I get this feeling in the upper abdomen on the day of an attack, the last one lasted all day like that butterfly feeling. I kind of know when it can happen sometimes as I get the feeling like its in the post and going to happen I just don’t know when.

I really do appreciate your advice and time taken to respond as I doctors I have seen even Cardiologists have never explained how to cope or why I get these episodes. They just do all the tests and if they come back normal want to get me out as soon as possible, this is very real and effects my life and everything I do. Thank You in advance RLR, Lee  
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RLR
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Re: 2nd and final qustion for RLR, Thank You
Reply #1 - Dec 20th, 2010, 3:24pm
 
Hi Lee,

Well, I certainly don't believe the episodic paroxysmal tachycardia to be psychological in origin. The sensations in your abdomen would suggest the effects of epinephrine (adrenaline). I would presume that your doctors have ruled out the presence of a pheochromocytoma or in more rare instances a paraganglioma. I doubt that it's the case here, but we want to be certain that it's been considered.

In most instances of PAT or PSVT, the cause is due to a re-entrant node that tends to excite the pacers in a cyclic manner that produces the rapid rate being experienced. Ablation procedures in some instances can be warranted, but I'm not certain whether you would necessarily be a candidate. In other cases, the disturbance can be entirely ideopathic, or in other words the cause is never identified.

Realize that exercising on an empty stomach does not preclude the manifestation of indigestion or other GI disturbance. Many times, hyperacidity can result from aggressive exercise programs and in some instances of errant reflux, acid that penetrates the esophageal corridor can indeed produce tachycardia. Also be aware that all caffeinated products increase acidity and elevate the central nervous system activity to at least some extent.

The fact that your cardiac evaluation panel was clear, literally means that the characteristic forms of pathology capable of inducing the problem are absent. Negative means negative with respect to test outcomes. So whatever is producing the syndrome as it relates to your activity or exercise level is being instrumented by other means, either the instance I spoke of regarding your GI circumstances or possibly your thyroid etc, etc. (not likely but possible nonetheless).

You're going to be fine and the cause can certainly be identified and treated in order to permit you the reaquisition of your lifestyle.

Best regards and Good Health
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Best Regards and Good Health
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